About Mary Ruth Velicki

Mary Ruth Velicki MS, DPT combines her experiences of healing through debilitating pelvic pain with her background as a physical therapist to provide inspiration and information for others who are suffering. In her memoir, Healing Through Chronic Pain, she describes how she used the body-mind-spirit connection to restore her health and well-being.

Dear Pope Francis,

a1Welcome to the United States! Thank you for your messages of healing, compassion and equality. The Roman Catholic Church has been an integral part of my life, and I wish to share my story with you and to speak for those who do not have a voice.

Eight years ago, intense pelvic pain pulled me out of my regular life. In order to get better, I tried a plethora of treatments from Western, Eastern and alternative sides of medicine. I also looked at the emotional issues that might have been causing such a ramp up of my nervous system and the continuation of my pain.

After about five years of healing through the layers, I remembered being raped at age four, five and nine by the priest who was the hero of my childhood. It was incredibly hard to believe, but it completely matched the memories I had kept and my siblings told me they knew it was true. I have learned that I am not alone; many children suppress sexual trauma, and it is common for people with chronic pelvic pain to have a history of sexual abuse.

As I worked for years to heal, I began to appreciate how this trauma had changed me. At age four, I lost my sense of connection to myself, to a loving God, and to my sense of a protective family/ community. On a very deep level I became fearful and hyper-vigilant. My nervous system became ramped up and this changed the tension in my muscles, the posture of my body, and eventually contributed to my debilitating pelvic pain.

The priest who raped me was eventually put in charge of managing the pedophiles in his diocese and moving them into positions where they were less likely to have contact with children. He told my mother that sometimes the priests reoffended, and this was difficult, but that even pedophiles deserved to be loved.

I agree. Everyone deserves love and a chance to heal, and many pedophiles have themselves been victims of childhood sexual abuse. However this culture of secrecy has been damaging for so many reasons. Healing for the offending priests will never happen in the dark where shame, blame, guilt and fear reside, and we need  transparency to stop the repetition of this abuse generation after generation. And most importantly, we need to protect the children because, as I’ve experienced, the ramifications of sexual abuse can be profound and can last a lifetime.

Over the years, I have looked honestly at my darker sides, released what I no longer wanted to carry and opened up to let more light and love flow through me and through my life. Healing is a process, but I have found that post-traumatic growth is truly possible. I think the same healing is needed by the full church, and especially in this area of sexual abuse. Thank you for being a part of this much-needed change. For all the children that have lived this experience, I encourage you to continue your efforts.

Sincerely,

Mary Ruth Velicki

Mary Ruth Velicki, MS, DPT, is the author of: Healing Through Chronic Pain. A Physical Therapist’s Personal Journey of Body, Mind, Spirit Transformation.

Healing for Every Body

HaysOver the years I have come to appreciate that healing is not just about becoming pain free. The cardiologist, Dean Ornish, says it well:
“Curing is when the physical disease gets measurably better. Healing is a process of becoming whole. Even the words heal, whole, and holy come from the same root. . . . In the process of healing, you reach a place of wholeness and deep inner peace from which you can deal with illness with much less fear and suffering and much greater clarity and compassion. While curing is wonderful when it occurs, healing is often more meaningful because it takes you to a place of greater freedom from suffering.”

Often when people heal on an emotional and spiritual level, they experience greater physical health, but this is not guaranteed and it isn’t always perfect. For example, when I’m stressed my nervous system still gets ramped up, my pelvic muscles go into a spasm and my bladder hurts. My body has experienced this pattern of pain and dysfunction for almost eight years, and it definitely knows how to get back there. But even though I occasionally feel pain, healing has changed how I experience it. Pain no longer defines me or throws me into despair, and even though I am physically uncomfortable sometimes I suffer so much less.

Healing is even possible when a physical condition gets worse. I watched this happen with my mother as she struggled with Amyotrophic Lateral Sclerosis (ALS) for seven years. On one of our last visits, I moved her paralyzed and bony frame up in bed and was shocked by frail she was because when you were with her it never seemed that bad. Perhaps this was denial on my part, but when I asked her friends and my family we all had the same experience. As my mother listened intently, savored her food, and watched the birds with delight, she was more alive than most of us with functioning bodies. She was fully present and this light of hers truly blinded one to the state of her body. As my mother was dying, she was healing.

In my second flare up of pain after being pain free for almost a year, I was completely discouraged. I was sitting in church when the speaker said, “You can be beaten down only to get up and be beaten down again. But while you are down there, only you can stop your heart from lifting.” For me this was so true. Healing was an active process of releasing resistance and letting more love and light flow within me. Rest assured that no matter where you are on the continuum of physical health, this type of healing is always an option.

photo by: Adrienne Hayes

How to Calm the Nervous System

DSCN5285Calming the Nervous System
The parasympathetic nervous system provides the body’s relaxation response and contains the hormones oxytocin, dopamine, and the endorphins. It is postulated that when the nervous system is relaxed, the body’s natural self-repair mechanisms flip on. Some activities that have been shown in the literature to activate the parasympathetic side of the nervous system include: meditation, massage, yoga, tai chi, creativity, friends, work you love, laughing, exercising, and playing with animals.

Joyful Activities
Consider what activities bring you joy, as this bumps up your endorphins and helps to calm the nervous system. I found that it wasn’t just the activity I chose, it was my mindset during the activity that made all the difference. Tuning into the body’s response during an activity is the easiest way to determine if an activity is a healing avenue for you.

Meditation
Just like there are many ways to activate the relaxed, joyful side of the nervous system, we each have different avenues that help us turn down the volume of our spinning minds. Several of my caregivers encouraged me to focus on one thing like the flame of a candle or a repeated phrase and to let the thoughts pass through without paying attention to them. Many people find these activities useful, but my mind was just too active. My thoughts were like children bursting into my mind, clamoring for attention, and bouncing off of each other with excitement. Occasionally, I could get my thoughts to come in and leave quietly, but then my body would speak up. My ramped up nervous system and tense muscles were giving my mind the message that it wasn’t safe and that the system was poised to run or fight at any moment.

Because my body and mind were conspiring for my survival, I needed to quiet both of them down at once. When I focused on the sensations of my body and breath and consciously moved them to a relaxed state, my mind moved out of stress-causing mental loops, and my body got the sensation that it was safe. For me, Hatha yoga, diaphragmatic breathing and progressive relaxation meditation were the most helpful in calming both my body and my mind.

Hatha Yoga
There are many types of hatha yoga and the experience will be different with each instructor. If your aim is to calm the body-mind, I suggest a non-stressful flow of poses and a non-competitive, peaceful environment with good breathing cues. When I close my eyes and focus on my breath and body sense, yoga becomes a calming, moving meditation.

Diaphragmatic Breathing
At the beginning of my illness, in the peak of pain, I was stopped at a light when I realized that I was breathing deeply with my diaphragm, which is the large, dome-shaped muscle that attaches to the lower ribs and spine and separates the chest from the abdominal cavity. When the diaphragm contracts, it flattens and moves downward, which squishes the abdominal contents and moves them outward.

When I told my physical therapist that I was automatically breathing with my diaphragm when my pain levels were high, she encouraged me to continue saying that this type of breathing is not only calming for the nervous system, it also automatically relaxes the pelvic floor muscles. So I began focusing on the rise of my belly with each breath when I was lying on my back or sitting in a chair with my feet flat on the ground.

Just recently, it occurred to me that breathing is not a conscious activity. So I let out all my air and then I just waited in a quiet state and soon my body took a big breath automatically. I allowed the exhalation without forcing it, and then I waited again for my body to breathe me. When I gave up control and just allowed the breath to happen, it felt less like an exercise and more like a meditation. Both me and my clients find this type of breathing to be highly effective in calming the body and mind.

Progressive Relaxation
I began practicing this type of progressive relaxation meditation at the beginning of my pelvic pain. I would focus on a body part, feel the tension, consciously try to let go, and then accept whatever tension remains. At first, I did this in sequence scanning all the areas from my feet to the top of my head or in reverse. But then over the years, I learned to scan my body and to focus on relaxing just the tense areas.

As the awareness of my body grew, I stopped directing this activity, and instead I would just lie in a quiet state with the intention of letting go any tension in my body that I was carrying. I would then just feel my body’s automatic responses, and as my body calmed down I often felt my muscles relax and the structure of my body adjust, and sometimes I would feel tingling in different areas, and increased digestion sounds.

Light Touch/ Massage
When I’m working with clients, certain physical techniques are effective in calming the body. Gentle rocking type motions of different body areas like the leg or the spine seem to decrease patterns of holding in the muscles and the area relaxes. Light touch and gentle stroking both sides of the spine starting at the head and travelling slowly down to where the spine meets the sacrum (the triangular bone at the base of the spine) can also help someone sink into relaxation.

Many of us have classic spots in the body that get tense when we are stressed, and when palpated these areas may feel ropy, knotty, tight or tender. When my nervous system is ramped up, it often comes with increased tension in my calves, buttocks (both superficial and deep muscles), the muscles on either side of the spine, the muscles at the top of the neck where it attaches to the head, and the deep muscles at the temporal-mandibular joint located near the earlobes where the jaw attaches to the skull. Learning how to find these spots helps reconnect you to your own body and to become aware of when you are stressed, and learning to care for your body in this way is empowering.

Deep massage or sustained pressure to the affected areas also seems to calm the whole nervous system. I often apply pressure using my fingers or other tools such as a small ball or foam roller. At first, I saw a massage therapist for this work, but over the years and with some instruction, I learned to find the spots myself and treat them. Some of my clients have a loved one care for them in this way. This is great when the areas are hard to reach, and it gives a partner something to do to help when you are in pain. When this care is done with love, the person receiving the treatment often feels safe and this can be calming in its own right.

Beyond the Medical Model

During a recent webinar focusing on the multi-dimensional nature of pain, the presenter suggested that many chronic conditions may be “autoimmune” in nature, and I felt myself recoiling a bit. I had been taught that in these conditions the immune system, which protects us from disease and infection, attacks the healthy cells in the body by mistake. When I was diagnosed with interstitial cystitis, I would occasionally hear the condition described as a possible autoimmune disorder, and the idea that my body was self-destructing made me feel helpless and fearful.

Over the years I gradually came to appreciate that this description of what is happening in the body is not the absolute truth, but rather one perspective from Western medicine. In the Middle Ages, the study of the body was separated from the investigation of the mind and considerations of the spirit, and medical science grew out of the need to fight off infection. The definition of an autoimmune disorder is a good example of this focused perspective. Symptoms are a direct reflection of mistakes made by the immune system, and the purpose of this system is to protect the body from invasion.

Over the healing years I had many experiences that challenged this perspective and broadened my view of the body from a machine to an intelligent organism. I began to appreciate that my body’s symptoms often reflected what was happening in my mind and spirit too, and sometimes my symptoms were directly related to my beliefs, thought patterns and emotional state. I began to appreciate that my body was not creating problems or attacking me. It was always trying to do its best to survive even when it got stuck in fearful and non-productive patterns. My body was never the enemy, but sometimes it needed help.

Challenging our perspectives about the body can change our beliefs about our illness and alter how we go about helping ourselves to heal. For example, in the case of an autoimmune disorder, the body could be seen as a machine that is attacking itself or as a protector whose responses are in a state of heightened alert. With this second perspective, instead of feeling helpless and afraid, we are empowered and encouraged to find ways to calm and support the body and to give the mind messages that it is safe.

It is true that we are definitely biological beings and the body often benefits from medical intervention. This singular focus has lead to vast knowledge of the body and advancement in medicine. Perhaps we are now ready to recombine this knowledge with an appreciation of our holistic nature. With this new mindset, we can learn to use the connection between our body, mind and spirit to help us heal on all levels.

The Fear Factor

fire

Kate came into my office in despair. She had suffered with sciatica for several months and she had just seen her MRI which showed a mild lumbar spine disc bulge and some pressure on the nerve root. She was worried that the pain would be there for the rest of her life or she would need surgery in order to get better.

Kate is not alone; many of the people I see in pain are frightened about the diagnosis they have received or by the scans they have been shown. This was my experience too, and remember being stunned and afraid when I saw my cervical disc bulges on MRI and when I was diagnosed with interstitial cystitis.

Kate visibly relaxed when I told her that the level of pain is not always directly related to the  severity of the structural problem in the body. As a physical therapist I have heard stories of clients with scary MRIs that are pain free, and others with just mild issues on the scan who are experiencing major pain. There is also evidence that physical signs on Xray and MRI are not directly related to the onset, duration severity or prognosis of low back pain.

To her surprise, Kate was pain free during yoga, meditation and after our session of holistic bodywork.  I too was surprised when I was pain free during yoga class at the start of my chronic pelvic pain condition. For both of us, the physical condition didn’t fully resolve during these therapies, but the pain decreased and this made us wonder if there was something more to our pain than a physical issue.

While we may have physical problems, pain is transmitted by the nervous system and is interpreted in the brain, and there are many factors related to whether these signals are transmitted. Studies on pain perception from the neuroscientist, Lorimer Moseley suggest that the level of pain experienced by a person may be directly related to the perceived threat of the stimulus. The brain receives all types of inputs and it filters out those that it deems crucial for survival, and when an input is considered threatening we may experience it as pain.

This theory matched my personal experience.  It has been eight years since my chronic pelvic pain began, and even though I am pain free on most days, my bladder pain and pelvic floor spasms rear up occasionally. Even though I have the same symptoms, I am now much less fearful  and can remain calmer in the storm. With this mindset, the condition seems to resolve more quickly, and the same symptoms are not as bothersome. When I worked to heal from my chronic neck pain, I attributed my decrease in pain to my physical therapy and home program and changes at the body level. And while this is true, I can now see how the resolution of my pain was related to mental/emotional factors too.  Finding therapists I trusted and actively working to recover gave me a sense of empowerment, and this decreased my fear. During both of my bouts with chronic pain, there seemed to be a direct feedback loop between my level of fear and the level of pain I experienced.

 

Willie the Healer

IMG_0131Willie showed up as a stray over ten years ago and was adopted by my neighbor four doors down.  He’s not particularily attached to me and when I pass him on my daily walk, he barely acknowledges me. But even with this cool reception, I still feel lots of love for him because when I was hurting he made a big effort to help me.

One morning as I stepped into the garage, the pain and tension in my pelvic floor area reared up, and I decided to sit on my heels and curl my body forward. I learned this position in yoga (child’s pose) and sometimes it helped to relieve the pain. While I was down there with my head close to the cement I heard Willie come into the garage. He put his head on mine and moved his paws with a rhythmical kneading motion and mewed and purred. I just let him do his thing. After several minutes, he stopped and I stood up, and the pain had dropped.

Then one afternoon, I was in my yard taking out the trash cans when the pain and tension in my low back and pelvis rose up. I squatted down next to the trashcan hoping to relax the area, and Willie showed up immediately and placed his body across my low back.

During the years when I was hurting, I often sat on my front porch in the dark and looked up at the stars. After a few minutes I would hear Willy mewing and it would get louder and louder as he made his way down the street with his paws sounding like a faint drumbeat on the sidewalk. As we sat together under the moonlight I often felt my body relax in his company.

Part of my healing process was to recognize that love was flowing around me all the time, and often where I least expected it. Willie was one of my first teachers. One night as we were sitting in the dark a thought popped into my head, “Let him love you.” And I did.

My Top Pain Management Strategies

IMG_0208

 

 

 

 

 

 

For those with chronic pelvic pain…here are the top six ways I manage my pain condition and deal with flare-ups when they occur:
1. Myofascial release techniques to affected areas in physical therapy and on my own.
2. Meditative activities that focus on the body such as diaphragmatic breathing, progressive relaxation meditation and yoga.
3. Reiki/ energy work: Treatment from therapists and on my own every day.
4. Introspection: Acknowledging my stress and looking within to determine thoughts/behaviors/emotions that may be contributing to a ramp up of my nervous system.
5. Singing (without restraint): This activity releases emotion and diaphragmatic breathing relaxes the pelvic floor muscles.
6. Activities that bring joy. For me this is visiting with friends, sitting at the ocean, and petting the neighborhood cat.

Taming the Tiger

imageArtwork by: Alana Alley

It has been a long time since I’ve been flared up… but here I am. With some help, I am now clear on the situation and the thoughts/emotions that are creating my stress. But beyond this detail… at a root level this stress is really fear.

This animal part of me wants to be safe and survive, and my body alarms are going off. For some of us sensitive souls and especially those of us who have experienced quite a bit of trauma in our lives, these alarms get triggered easily. Perhaps they even stay on at a low level just to make sure we are going to be okay.

At times, this fear has been out of proportion to the danger at hand and it has created stress, inflammation and pain in my body.

There is a part of me that understands that when I turn my thoughts from fear to love- both my body and mind can settle in a peaceful place. But when I’m really stressed another part of me shouts, “How can you talk about love? It feels like I’m running from a tiger!”

Then the peaceful voice chimes in again, “Look again. Sometimes that tiger has been created by your mind. Take a breath. You are safe.”

Breaking the Stress Link

jacquelinebakker

IC/PBS can create pain and inflammation in the bladder, and stress can be a big factor in creating this inflammation.

The human body reacts to stress by pumping adrenaline and then cortisol into the bloodstream to focus the mind and body for immediate action. This amazing response has ensured our survival throughout the ages.

Cortisol in small doses is very helpful, and it turns off the inflammatory response. But when the stress is prolonged and the cells are exposed to a relentless stream of cortisol, they can become desensitized to the hormone. This can create excessive inflammation in the body.

 Consider these ways to break the link between stress, inflammation and pain:

  1. Eat wholesome, anti-inflammatory foods and consider adding fish-oil and supplements to your diet.
  2. When it possible, limit your exposure to situations and people that ramp up your stress.
  3. Look within and consider what thought patterns and emotions might be increasing your stress and try to change them in a positive direction.
  4. Release stress through exercise. When you are hurting, consider low impact activities such as swimming and walking.
  5. Find ways to turn on the parasympathetic/relaxed mode of your nervous system. Consider some of these activities that have been supported by research: meditation, creativity, massage, yoga, tai chi, friends, work you love, laughing, exercising, and playing with animals.

Photo by: Jacqueline Meltcher Baker
www.healingthroughchronicpain.com